A recent Illinois Appellate Court case reviewed what a drug store’s duty is to its customers regarding possible drug interactions in an Illinois pharmaceutical lawsuit. In DiGiovanni v. Albertson’s, Inc., No. 04 L 3580, the decedent’s estate alleged that the pharmacy had a duty to warn the decedent about a possible interaction between her two prescribed medications, an interaction that eventually caused her death. However, both the Cook County trial court and the appellate court agreed that the pharmacy did not have a duty to warn the customer of the possible drug interaction in the present pharmaceutical malpractice case.
The decedent had been prescribed Tenoretic, a medication to treat high blood pressure, by her longtime doctor, Dr. Shastri. When filling the prescription the pharmacy noted that Tenoretic could interact with lithium, which the decedent was also taking to treat her manic depression. Upon noting the possible interaction the pharmacist called Dr. Shastri, who had prescribed both medications, to determine whether he should continue to fill both prescriptions. Dr. Shastri directly told the pharmacist to fill the prescriptions and stated that he would monitor the decedent for possible interactions.
The following week DiGiovanni returned to the same pharmacy for a prescription refill of the same medications. At the time a different pharmacist again noted the possibility of a drug interaction between the two medications. However, the pharmacist refilled both prescriptions after reviewing a note on the decedent’s file indicating that her doctor would be monitoring her for possible drug interactions.
According to the estate the pharmacy had a duty to the decedent to warn her of the possible interaction between Tenoretic and lithium and the potential for lithium toxicity. While the prescribing physician was involved in the lawsuit the trial court tended to agree with the decedent’s estate that the pharmacy did have a duty to warn. However, once the defendant doctor was released from the court proceedings after settling with the estate, the trial court found that under the learned-intermediary doctrine the pharmacy did not have a further duty to warn the decedent.
The learned-intermediary doctrine holds that prescription drug manufacturers have a duty to warn prescribing physicians of a drug’s dangers and that the physician in turn has a duty to convey that warning to patients. In general, the learned-intermediary doctrine has not applied to pharmacies or pharmacists and is meant to address drug manufacturers’ duty to indirectly warn patients.
The appellate court held that the pharmacists fulfilled their duty to the patient by contacting the prescribing physician regarding the potential interaction. The court was not disposed to imposing a stricter doctrine on the pharmacy as this could place its duty at a higher level than that of the drug manufacturer who simply has to convey a drug’s danger to a physician and not the patient directly. Similarly, a pharmacy only has a duty to warn the prescribing physician about any inherent dangers.
In turn, the prescribing physician then has the duty to apply his/her medical judgment and warn the patient of possible dangers. However, the issue of this appeal was not the physician’s duty as he had already settled with the decedent’s estate. The case against the pharmacy was dismissed, putting an end to the decedent’s pharmaceutical litigation lawsuit.
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